Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC
OBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: An...
| Autores: | , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión aceptada para publicación |
| Fecha de publicación: | 2018 |
| País: | España |
| Institución: | Universitat Pompeu Fabra |
| Repositorio: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/36036 |
| Acceso en línea: | http://hdl.handle.net/10230/36036 http://dx.doi.org/10.1016/j.medin.2018.02.002 |
| Access Level: | acceso abierto |
| Palabra clave: | Grip A (H1N1) Critically illness Enfermedad crítica Infección por virus influenza A (H1N1)pdm09 Influenza A (H1N1)pdm09 virus infection Intensive Care Unit Manejo terapéutico Mortalidad Mortality Outcome Pronóstico Therapeutic management Unidad de Cuidados Intensivos |
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Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUCMarin Corral, JudithCliment Company, María CristinaMuñoz Bermudez, RosanaSamper Echevarria, MariaDot Jordana, Irene, 1982-Vilà Vilardell, ClaraMasclans Enviz, Joan RamonRodríguez, AlejandroMartín Loeches, IgnacioÁlvarez Lerma, FranciscoH1N1 GETGAG/SEMICYUC Study GroupGrip A (H1N1)Critically illnessEnfermedad críticaInfección por virus influenza A (H1N1)pdm09Influenza A (H1N1)pdm09 virus infectionIntensive Care UnitManejo terapéuticoMortalidadMortalityOutcomePronósticoTherapeutic managementUnidad de Cuidados IntensivosOBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: Analysis of 2 groups according to the epidemic period of the diagnosis (2009-2011; 2013-2015). VARIABLES: Demographic, temporal, comorbidities, severity, treatments, mortality, late diagnosis and place of acquisition. RESULTS: A total of 2,205 patients were included, 1,337 (60.6%) in the first period and 868 (39.4%) in the second one. Age and severity on admission were significantly greater in the second period, as well as co-infection. With regard to the impact of the recommendations, in the second period the diagnosis was established earlier (70.8 vs. 61.1%, P<.001), without changes in the start of treatment. Patients received less corticosteroid treatment (39.7 vs. 44.9%, P<.05), more NIMV was used (47.4 vs. 33.2%, P<.001) and more vaccination was made (11.1 vs. 1.7%, P<.001), without changes in mortality (24.2 vs. 20.7%). A decrease in nosocomial infection was also noted (9.8 vs. 16%, P<.001). Patients needed less MV with more days of ventilation, more vasopressor drug use and more ventral decubitus. CONCLUSIONS: The management of patients with severe influenza A (H1N1) has changed over the years, though without changes in mortality. The recommendations of the SEMICYUC (2012) have allowed earlier diagnosis and improved corticosteroid use. Pending challenges are the delay in treatment, the vaccination rate and the use of NIMV.Elsevier20182018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/36036http://dx.doi.org/10.1016/j.medin.2018.02.002reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraEspañolMedicina intensiva. 2018 Nov;42(8):473-81© Elsevier http://dx.doi.org/10.1016/j.medin.2018.02.002info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/360362026-06-12T07:21:37Z |
| dc.title.none.fl_str_mv |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| title |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| spellingShingle |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC Marin Corral, Judith Grip A (H1N1) Critically illness Enfermedad crítica Infección por virus influenza A (H1N1)pdm09 Influenza A (H1N1)pdm09 virus infection Intensive Care Unit Manejo terapéutico Mortalidad Mortality Outcome Pronóstico Therapeutic management Unidad de Cuidados Intensivos |
| title_short |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| title_full |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| title_fullStr |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| title_full_unstemmed |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| title_sort |
Pacientes con Gripe por Virus Influenza A (H1N1)pdm09 ingresados en UCI. Impacto de las Recomendaciones de la SEMICYUC |
| dc.creator.none.fl_str_mv |
Marin Corral, Judith Climent Company, María Cristina Muñoz Bermudez, Rosana Samper Echevarria, Maria Dot Jordana, Irene, 1982- Vilà Vilardell, Clara Masclans Enviz, Joan Ramon Rodríguez, Alejandro Martín Loeches, Ignacio Álvarez Lerma, Francisco H1N1 GETGAG/SEMICYUC Study Group |
| author |
Marin Corral, Judith |
| author_facet |
Marin Corral, Judith Climent Company, María Cristina Muñoz Bermudez, Rosana Samper Echevarria, Maria Dot Jordana, Irene, 1982- Vilà Vilardell, Clara Masclans Enviz, Joan Ramon Rodríguez, Alejandro Martín Loeches, Ignacio Álvarez Lerma, Francisco H1N1 GETGAG/SEMICYUC Study Group |
| author_role |
author |
| author2 |
Climent Company, María Cristina Muñoz Bermudez, Rosana Samper Echevarria, Maria Dot Jordana, Irene, 1982- Vilà Vilardell, Clara Masclans Enviz, Joan Ramon Rodríguez, Alejandro Martín Loeches, Ignacio Álvarez Lerma, Francisco H1N1 GETGAG/SEMICYUC Study Group |
| author2_role |
author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Grip A (H1N1) Critically illness Enfermedad crítica Infección por virus influenza A (H1N1)pdm09 Influenza A (H1N1)pdm09 virus infection Intensive Care Unit Manejo terapéutico Mortalidad Mortality Outcome Pronóstico Therapeutic management Unidad de Cuidados Intensivos |
| topic |
Grip A (H1N1) Critically illness Enfermedad crítica Infección por virus influenza A (H1N1)pdm09 Influenza A (H1N1)pdm09 virus infection Intensive Care Unit Manejo terapéutico Mortalidad Mortality Outcome Pronóstico Therapeutic management Unidad de Cuidados Intensivos |
| description |
OBJECTIVES: To evaluate the impact of the recommendations of the SEMICYUC (2012) on severe influenza A. DESIGN: A prospective multicenter observational study was carried out. SETTING: ICU. PATIENTS: Patients infected with severe influenza A (H1N1) from the GETGAG/SEMICYUC registry. INTERVENTIONS: Analysis of 2 groups according to the epidemic period of the diagnosis (2009-2011; 2013-2015). VARIABLES: Demographic, temporal, comorbidities, severity, treatments, mortality, late diagnosis and place of acquisition. RESULTS: A total of 2,205 patients were included, 1,337 (60.6%) in the first period and 868 (39.4%) in the second one. Age and severity on admission were significantly greater in the second period, as well as co-infection. With regard to the impact of the recommendations, in the second period the diagnosis was established earlier (70.8 vs. 61.1%, P<.001), without changes in the start of treatment. Patients received less corticosteroid treatment (39.7 vs. 44.9%, P<.05), more NIMV was used (47.4 vs. 33.2%, P<.001) and more vaccination was made (11.1 vs. 1.7%, P<.001), without changes in mortality (24.2 vs. 20.7%). A decrease in nosocomial infection was also noted (9.8 vs. 16%, P<.001). Patients needed less MV with more days of ventilation, more vasopressor drug use and more ventral decubitus. CONCLUSIONS: The management of patients with severe influenza A (H1N1) has changed over the years, though without changes in mortality. The recommendations of the SEMICYUC (2012) have allowed earlier diagnosis and improved corticosteroid use. Pending challenges are the delay in treatment, the vaccination rate and the use of NIMV. |
| publishDate |
2018 |
| dc.date.none.fl_str_mv |
2018 2018 |
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info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion |
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article |
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acceptedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10230/36036 http://dx.doi.org/10.1016/j.medin.2018.02.002 |
| url |
http://hdl.handle.net/10230/36036 http://dx.doi.org/10.1016/j.medin.2018.02.002 |
| dc.language.none.fl_str_mv |
Español |
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Español |
| dc.relation.none.fl_str_mv |
Medicina intensiva. 2018 Nov;42(8):473-81 |
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© Elsevier http://dx.doi.org/10.1016/j.medin.2018.02.002 info:eu-repo/semantics/openAccess |
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© Elsevier http://dx.doi.org/10.1016/j.medin.2018.02.002 |
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openAccess |
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application/pdf application/pdf |
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Elsevier |
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Elsevier |
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reponame:Repositorio Digital de la UPF instname:Universitat Pompeu Fabra |
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Universitat Pompeu Fabra |
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